Survival guilt and the Vietnam veteran

The author describes the phenomenology and clinical characteristics of survival guilt which can be found in many Vietnam veterans. This conflict, in its most acute presentation, typically resembles an agitated depression. The syndrome is characterized by the veterans' frequent dreams of their friends dying in battle, and by their avoidance of interpersonal intimacy because they fear the other party may abandon them or die. The section on treatment recommendations emphasizes the importance for psychotherapists to confront continuously the veterans' many self-destructive patterns of behavior. Psychotherapy should also address any false beliefs the veterans may entertain regarding the nature of their survival.